Professionalism in support of pediatric cardio-thoracic surgery: A case of a bright young surgeon (October 2011)

Summary

Effective teamwork is critical to successful outcomes in pediatric cardiac surgery. Unfortunately, lapses in professional performance and conduct by those who treat paediatric cardiac patients pose threats to quality and safety.

One hallmark of a profession is self regulation. Therefore, healthcare leaders need specific means for identifying and addressing those lapses and indicators of unsafe systems or individuals. This article from Pichert et al. describes an initial “near miss” event involving a paediatric cardiac surgeon. While fictional, the case represents a composite of events involving several paediatric cardiac surgeons who practice at different medical centers throughout the US.

Content

Research shows that patient complaints are significantly associated with physicians' risk management activity and lawsuits. Research also demonstrates that a small subset of physicians and surgeons in various areas of practice are associated with disproportionate shares of patient complaints.

Coded and aggregated patient complaint data therefore offer a metric for identifying and promoting behavior change. Analysis of the distribution of patient complaints associated with 41 paediatric cardiac surgeons is presented as a means for helping leaders show one surgeon how her/his risk status compares with peers. The paper describes a specific plan and reliable process by which medical group/centre colleagues and leaders may:

1. address lapses in professionalism and performance;
2. follow-up to promote professionalism, professional accountability, quality, and a safety culture; and
3. reduce risk.